Category Archives: Emergency.Services

A settlement has been finalized between the US Occupational Safety and Health Administration and Altamont Ambulance Service. OSHA opened investigations in January 2016, after receiving a complaint alleging violations of OSHA’s bloodborne pathogens exposure and various other health and safety standards. … Six different activities were alleged in January 2016. Two of those alleged violations by Altamont Ambulance, two by Effingham City/County Ambulance and two by Vandalia Ambulance. The current penalties total $149,000. The initial penalties totaled $379,000. Altamont Ambulance has ceased operations in Effingham County and Fayette County.

Federal safety and health investigators found Altamont Ambulance Service Inc. failed to follow specific guidelines to protect emergency healthcare workers from exposure to bloodborne pathogens and other hazards while providing patient care. On July 6, the Department of Labor’s Occupational Safety and Health Administration issued five willful, 16 serious and three other-than-serious safety and health violations to the emergency medical service provider with proposed penalties of $290,100. The agency opened inspections in January 2016, after receiving a complaint alleging violations of OSHA’s bloodborne pathogen exposure and various other health and safety standards. …

… The agency’s Fairview Heights area office found the employer failed to:

Establish an exposure control plan for bloodborne pathogens and other potentially infectious material.

Make Hepatitis B vaccination series available to employees.

Train workers about chemical and bloodborne pathogen hazards and precautions.

The U.S. Occupational Safety and Health Administration has opened an inspection of already-embattled Altamont Ambulance Services, Inc. The administration opened the inspection Jan. 6, according to the OSHA website. Area Director Aaron Priddy of the administration’s Fairview Heights office would not go into specifics about the probe, but he confirmed there has been a complaint filed against the service. Altamont Ambulance has been the sole emergency ambulance provider in Effingham County since 2004. In November 2014 the county sought to open the ambulance market to other providers, but that move is tied up in court. …

A local family is demanding answers from an ambulance company. William Scanlon’s family said they have a number of questions after he died on his doorstep when he was transported home from the hospital. They say he needed oxygen to breath, but that for some reason, when an American Medical Response ambulance transported him back home Saturday morning, with temperatures hovering near zero, not only was he not hooked up to oxygen, they say the ambulance crew also made him walk. … AMR said it expects to finish up its internal investigation soon. The family said they’ve already met with a lawyer and are filing a lawsuit against the company.

Back in October, the Project On Government Oversight did a top-level analysis of federal government spending on Hurricane Harvey, Irma, and Maria recovery contracts, as reported by the Federal Procurement Data System (FPDS). The FPDS spreadsheets contain a wealth of data that allow the public to track billions of dollars in federal contract expenditures in precise detail: the agency awarding the money, the amount, the purpose, and the recipient. At that time, the government had spent a total of $1.65 billion on contracts. However, FPDS imposes a 90-day delay on the release of Department of Defense (DoD) data, so we were missing a big piece of the spending puzzle. Now, DoD numbers are starting to trickle in and we are getting a more complete picture of federal contracting outlays for the recovery efforts in Texas, Louisiana, Florida, Puerto Rico, and the Virgin Islands. The federal contract award total now stands at $3.3 billion: $1.2 billion for Harvey, $726 million for Irma, and $1.4 billion for Maria. … Federal expenditures on Hurricane Harvey, Irma, and Maria contracts have now surpassed the $3 billion spent for Hurricane Sandy and are steadily approaching the $20 billion total for Hurricane Katrina. As the total grows, so too will the misuse of those funds. To that end, POGO plans to release a database that will track all federal spending relating to Hurricane Harvey. …

People in Central should expect another five years of their government services coming from private contractor IBTS after the company won praise Tuesday evening from both Mayor Jr. Shelton and the Central City Council. IBTS, the Institute for Building Technology and Safety, has spent the past seven years running government services in Central, where the number of city government employees can be counted on one hand. The not-for-profit, Virginia-based company was one of two that bid for the contract to run services that other City Halls hire government employees to accomplish. IBTS offered its services starting at $3.9 million annually and working up to $4.4 million in the final year of a five-year contract. … One big change Shelton said Central wants from IBTS is to beef up emergency services. The August 2016 floods exposed a weak spot in Central’s privatized system of government — the lack of personnel and resources available on a round-the-clock basis to respond to disasters, he said. … CH2M Hill provided city services before IBTS took over.

A new report by the Nassau Interim Finance Authority (NIFA) suggests the county should eliminate crossing guards, privatize ambulance services and close its Marine Bureau in an effort to close a $54 million deficit. CSEA President Jerry Larrichuita says he’s outraged by language in the report that suggests many of the proposed cuts would not have an impact on county services. “I think they should stick to banking, which is their job, and stay out of government operations,” says Larrichuita. …

Last summer the state awarded Securitas a three-year, $130 million contract for security at all Hawaii airports. …The Hawaii Government Employees Association, meanwhile, is questioning whether private security guards are qualified or legally authorized to have police powers. The union contends that, over the years, the DOT has allowed Securitas to expand its role. …

The state Transportation Department did confirm that it had given the Public Safety Department a 180-day notice of its intent to terminate an agreement to station 57 deputy sheriffs at the airport. But Fuchigami said he wants to work out a new agreement that gives deputy sheriffs new duties and better coordinates security operations at the airport. … Despite reassurances that the sheriff’s department will remain part of the airport’s security detail the sheriff’s union believes this shake up is an attempt to drive it’s deputies out. “That is our biggest concern that this is just another step toward privatizing law enforcement at the airport and that is something we violently object to,” said Randy Perreira, HGEA Executive Director.

Major changes are in the works at Daniel K. Inouye International Airport with regards to security. The Hawaii Department of Transportation sent a letter to the Department of Public Safety to say deputy sheriffs will no longer be patrolling the airport. The Department of Public Safety tells us it has 57 deputy sheriffs and two civilians working at Honolulu’s airport. … Deputy sheriffs belong to the Hawaii Government Employees Association. The union filed a lawsuit against the state last year because it allowed Securitas to take over some of the law enforcement duties at all of Hawaii’s airports. We asked about this latest issue, and received the following statement from Randy Perreira, HGEA executive director: “HGEA is aware of the letter from the State Department of Transportation to the Department of Public Safety regarding termination of services of State Sheriffs at Daniel K. Inouye International Airport. We are working to get more information regarding this issue.

The U.S. Department of Justice continues to build its case against East Texas Medical Center and its ambulance division, Paramedics Plus, in what they say is a $20 million kickback scheme to ensure Paramedics Plus retained lucrative contracts. Most recently, Justice Department attorneys filed a list of people they expect to depose in coming months. In all, more than 100 people could be deposed as this case moves forward. The government also filed a proposed schedule, which outlines when fact discovery will take place, when expert discovery will occur, deadlines for motions and trial preparation and finally, an expected timeframe for the start of the trial – summer of 2018. … In January, the Justice Department announced it would intervene in a lawsuit against ETMC and Paramedics Plus brought by a whistleblower – former employee Stephen Dean, who was Paramedics Plus chief operating officer. According to the suit, ETMC and Paramedics Plus paid more than $20 million in kickbacks and bribes, including cash payments to Oklahoma officials. …

Former U.S Attorney Brian Albritton told Pinellas County Commissioners Tuesday that a federal lawsuit alleging ambulance fee kickbacks could have cost taxpayers as much as $1 billion if they lost in court. Commissioners agreed to settle the case involving Paramedics Plus Sunstar ambulance service for $92,700 and to forgo an estimated $500,000 in uncollected ambulance fees from patients. They will also have to pay legal fees to Albritton who the county secretly hired last year to resolve the case. Pinellas commissioners discussed the case publicly Tuesday for the first time since Eight On Your Side first broke the story of alleged kickbacks and a federal investigation of Pinellas County’s ambulance contract last month. That settlement, signed March 7 by Vice-Chair Kenneth Welch, requires the county to pay $92,700 to federal prosecutors, the Florida Attorney General and attorneys for the whistleblower–a former executive with Paramedics Plus. It also requires Pinellas County to turn over all documents and evidence gathered in the course of the county’s own internal investigation, and to cooperate with an ongoing federal investigation and whistleblower action filed against Paramedics Plus in Texas.

… Since 2004, Paramedics Plus has operated as Pinellas County’s exclusive ambulance provider under the county-owned brand name Sunstar. The current county contract with Paramedics Plus amounts to about $50 million a year. In 2014, a former high-ranking executive of Paramedics Plus filed a whistleblower action in Texas that alleged an ongoing ambulance fee kickback scheme that stretched from Pinellas County to Oklahoma and California for over a decade. The scheme alleged by the whistleblower and federal prosecutors in a related legal action included so-called “profit cap” rebates that essentially funneled overcharges from Medicaid and Medicare to Pinellas County and other local governments that oversee public ambulance contracts. County leaders in Pinellas insist the “rebates” or “kickbacks’ in Pinellas totaled only $35,000 or so and ended up in county bank accounts, not someone’s pockets. In Oklahoma, the whistleblower suit alleges those kickbacks amounted to as much as $20 million. Federal prosecutors in Texas have cited specific acts of corruption in Oklahoma that include kickbacks, political payoffs and self-enrichment involving Paramedics Plus executives and government overseers in Oklahoma. … Pinellas County Administrator Mark Woodard says the settlement has no impact on the county’s ongoing $50 million a year contract with Paramedics Plus because the company has not been charged criminally or been found guilty of anything.

A Texas health system paid an Oklahoma agency and its president $20 million in cash bribes in exchange for lucrative ambulance service contracts over 15 years, federal prosecutors said ( United States ex rel. Dean v. Paramedics Plus, LLC , E.D. Tex., No. 14-cv-203, complaint in intervention 1/23/17 ). The U.S. Attorney’s Office for the Eastern District of Texas partially intervened Jan. 23 in a whistle-blower lawsuit, filed under court seal in 2014, accusing East Texas Medical Center Regional Healthcare System (ETMC) of paying the kickbacks to Oklahoma’s Emergency Medical Services Authority (EMSA). Specifically, the government said ETMC concocted the kickback scheme with EMSA president and co-defendant Herbert S. Williamson, and paid the kickbacks through checks, bank wires and inflated service contracts, mostly through ETMC’s ambulance service company, Paramedics Plus LLC. The government said it paid the defendants over $70 million in Medicare reimbursements and over $38 million in Medicaid reimbursements just from 2009 through 2013, and it was seeking treble damages on all payments tainted by the kickback scheme, plus monetary penalties for each individual false claim submitted. The FCA authorizes monetary fines of up to $11,000 for each false claim submission. The U.S. Attorney’s Office declined to comment on whether criminal charges against Williamson would be coming in the future. … The complaint describes how Paramedics Plus, which contracted with the EMSA to provide ambulance services within the EMSA’s jurisdiction, was forced to “cut corners” due to the amount of its revenue that went to paying kickbacks. Paramedics Plus “avoided training and personnel expenses” to make sure enough money was available to pay kickbacks to the EMSA and Williamson, according to prosecutors. The complaint alleges Paramedics Plus executives were forced to forgo paying drivers and paramedics retention bonuses to stem high paramedic turnover because the company “would not have enough excess profits to make [Williamson] whole.”

Jacksonville State University police are set to return to in-house dispatch services in July, less than a year after outsourcing those duties in the expectation of improved efficiency. JSU officials now say contracting out the emergency and non-emergency medical calls hasn’t made the dispatch service more efficient. The JSU police will instead use a combination of professional dispatchers and student workers to handle all emergency and non-emergency calls moving forward. JSU police Chief Shawn Giddy sent a letter to Calhoun County 911 Monday stating his department no longer wanted the organization to manage its dispatch services. …

Alameda County supervisors extended their ambulance contract with Paramedics Plus by three years despite fierce criticism by firefighters complaining the process wasn’t open for competitive bids and changes in service delivery were not included. … The agreement will lessen fines for failures to hit response times, saving the company about $3.5 million, along with other givebacks from the county, such as reimbursements for some 5150 (mentally unstable) transports and a continued break from paying support fees totaling about $5.5. million annually. The company has said it is bleeding money during its contract and needed the breaks, especially from the “draconian” fine system. Firefighters have complained that the extension should not have been awarded without a proper open bidding process. They believe ambulance service has suffered, and a change to the delivery system, similar to the Contra Costa County model pairing firefighters with private ambulance companies, is preferable. The vote came days after a judge dropped Alameda County from a federal lawsuit alleging it accepted illegal kickbacks from Paramedics Plus. The county was dropped from the suit because it agreed in April to pay $50,000 to the feds and $21,000 in attorney fees for accepting payments from the ambulance company. The company claims the agreement was legal. …

The private-public partnership, apparently the first in California, is probably the best option available because it should slightly speed response time and reduce service duplication, and might enable the county to tap some federal dollars that would otherwise be lost. … But Contra Costans should realize that the plan carries downside financial risk and, contrary to some suggestions, probably won’t provide significant upside benefits for the beleaguered Contra Costa Fire Protection District for years, if at all. … An outside consultant, using current collection rates, estimates that the fire district will collect $39 million the first year and pay out, primarily to AMR, $37 million, netting a $2 million profit. But there are two major caveats. First, the consultant, former Livermore-Pleasanton Fire Chief Stewart Gary, warns in his analysis that declining numbers of patients with insurance to fully cover ambulance bills makes projections difficult and presents “one of the largest risks.” Second, the new venture will need about $9 million of seed money to cover early operations before bill payments start coming in. That advance will come from the fire district’s reserves and must be repaid.

In a search to further savings in a cash-strapped district, Contra Costa Fire has proposed a new partnership with its longtime ambulance provider, American Medical Response. ConFire will take over responsibility for billing and collecting insurance reimbursements as well as the liability if anticipated revenue doesn’t materialize. AMR will essentially function as a subcontractor providing ambulances and paramedics for a set fee. The new approach comes with added risks for taxpayers, but CityGate said that declining insurance reimbursements threaten all public agencies responsible for providing ambulance services. If private providers can’t turn a profit, they said, taxpayers could be asked to keep them afloat. Alameda County’s ambulance provider, Paramedics Plus, recently asked for an injection of $5 million of public funds to cover some of its losses. Contra Costa supervisors said they were still on board with ConFire’s plan and directed the county to proceed with negotiating a five-year contract that would take effect next year.

The Independence and South Platte emergency medical services union will get some of what it has asked for in its long-running contract dispute with American Medical Response. But the bulk of the fight still lies ahead. Members of the EMS Workers United-Local 1812, which represents emergency medical technicians, paramedics and dispatchers, have been circulating petitions to require Colorado-based AMR to regularly report employee turnover data to Independence officials. They planned to present the petitions to the Independence City Council at its meeting Monday. … Warth said the turnover data will be presented monthly at meetings of the emergency services committee, which includes representatives of the Independence police, fire, AMR and Centerpoint Medical Center. The committee meets every second Thursday. Robert Mills, a member of the EMS Workers United-Local 1812 bargaining team, said he was at the May meeting Thursday morning and no mention was made of the new data-sharing agreement. …

Members of the EMS Workers United-American Federation of State, County and Municipal Employees (AFSCME) Local 1812, which has been in contract negotiations with AMR for a year, say their turnover rate is too high due in part to fatigue and burnout from too many extra-long shifts – potentially putting patients at risk. They want the city’s health department and Emergency Services Committee that advises Health Director Andrew Warlen to have access to employee satisfaction and turnover data on a regular basis. Such a transfer of information is not uncommon in other municipalities contracted with AMR, they say. Furthermore, they believe Warlen is within his authority in the city code to request it. On March 23 the union filed an unfair labor practice charge with the National Labor Relations Board to obtain employee satisfaction information for themselves from the ambulance company. …

The union that represents emergency service technicians with the American Medical Response (AMR) are in a dispute with the city of Independence and the company. EMS Workers United-AFSCME said the city isn’t asking tough questions and the company isn’t being transparent, that they say that could put lives in danger. … According to her union, the employee turnover rate last year was 23 percent twice the national average. … In Independence, the city’s health director monitors response times monthly. Union members want him to do more that. “That’s currently the only metric that the city is measuring, then we’re not getting a full picture of our emergency care here,” Robert Mills, an EMT at AMR, said. … But the union points to ordinance SEC. 19.04.004. A.1 in the city’s code that allows the health director to request more reports in additional to response times.